How can we promote academic GP careers? A qualitative framework analysis of factors affecting the development of the academic GP workforce

Objectives General practice continues to be an under-represented career choice among medical school graduates, and the retention of the general practitioner (GP) workforce remains challenging. Academic general practice (AGP) is vital to the development of the evidence base for general practice and the education of the next generation of doctors and GPs. Academic careers and portfolio careers in general practice are seen as a means of increasing retention of GPs in the profession. However, AGP remains largely invisible to many and the number of AGPs is declining. There is no clear understanding of the reasons for this. The aim of this study was to explore factors that inhibit and promote AGP careers. Design Secondary framework analysis of data from two qualitative studies. Participants, setting and measures 41 GPs, GP trainees and Academic GPs (25 females and 16 males) across Scotland. Analysis of the data employed a framework based on Feldman and Ng's model of the factors influencing career mobility, embeddedness and success in order to explore the barriers and enablers to GPs developing academic careers that exist at multiple levels from the personal to the structural. Results GPs encountered barriers to entering AGP at multiple levels. Lack of clarity and visibility of training pathways, including the lack of clear routes into academia at multiple career stages, were significant barriers, as were the effects of taking on academic work on overstretched practices, and relative job insecurity and lower pay in academic careers. Conclusion The findings of this research demonstrate that unless the structural issues affecting the profession more generally are addressed, significant barriers to pursuing AGP careers will remain.